基于改良德尔菲法构建《女性尿失禁针灸临床实践指南》临床问题

以世界针灸学会联合会（WFAS）标准《女性尿失禁针灸临床实践指南》临床问题确定的专家共识为例,围绕指南研制组专家三轮德尔菲法调研临床问题的具体过程及结果,系统分析改良德尔菲法与针灸类专家共识的契合度以及本次共识过程的反思与不足,以期为同领域针灸指南的研制提供参考。     

临床实践指南推荐意见中针灸方案的制订及撰写建议

目前国内外针灸相关临床实践指南的推荐意见中,针灸方案来源不透明,缺乏针灸方案合理性的综合评价,且对于针灸方案选择的标准不透明、不规范,撰写及报告细节不足,导致指南的临床适用性受到影响,一定程度上降低了指南推荐意见的使用率。本文从针灸方案的来源、合理性综合评价、优先性选择以及撰写与报告几个方面进行探讨,并提出详细的方法学建议,以期为指南制订者提供临床指南推荐意见的针灸方案评价、选择和撰写的方法学优化思路及建议。     

Ezrin蛋白在肿瘤转移中的作用及机制研究

肿瘤转移是肿瘤恶化及死亡的主要原因,近年来研究发现,许多microRNA(miR)、蛋白分子、细胞信号转导通路等均可介导肿瘤迁移侵袭.Ezrin蛋白又称细胞绒毛蛋白,属埃兹蛋白/根蛋白/膜突蛋白(Ezrin/Radixin/Moesin,ERM)家族最早发现的一员,广泛分布于人体细胞内,是细胞骨架与细胞膜之间的连接蛋白...     

《过敏性鼻炎针灸临床实践指南》临床问题征询

The survey aims to collect clinical questions for the clinical practice guideline on acupuncture and moxibustion in treating allergic rhinitis. The survey is consisted of multiple-choice questions, ranking questions, and open questions. Readers are recommended to complete the open questions using PICO (Patients, Intervention, Comparator and Outcome) framework, referring to the examples. The survey might take about 30 min, and the responses from readers will greatly contribute to the formation of this guideline.     

外中风今释

通过对古代文献中的中风研究,梳理中医对中风认识的发展沿革,认为外中风是唐宋以前医家对于中风病的病机概括,指由于感受以风邪为主的六淫邪气所导致的以喎僻不遂、言语不利、甚则卒然昏仆、不省人事为主要表现的一类病证.外中风的基本病机为正虚邪中.结合现代医学神经系统相关疾病,阐释当代的外中风,认为中枢神经系统感染性疾病初期有发热、恶寒、体痛等表证,继而出现肢体失用、意识障碍等症状,可以从外中风去认识.     

基于“损其心者,调其营卫”论抑郁症辨治

针对抑郁症高发病率、高致残率及从肝郁气滞辨治不能解释该病复杂多样病机变化的现状,依据营卫理论,提出抑郁症病位在心,当调理营卫辨治的新思路。指出营卫与心气心血的运行以及心神主导脏腑气化功能密切相关,情志刺激、饮食不节、劳逸失度、天气变化等因素交互影响机体,致卫气郁痹、营血滞涩,营卫失调,累及于心,最易形成心气郁而不达;心血失充,心神主导失司,久则伤及脑髓,出现神机抑遏的病机变化,导致形神共病的抑郁症。临床基于"损其心者,调其营卫",选用桂枝汤类方调营卫、振心气、强神机,可有效治疗抑郁症。     

《过敏性鼻炎针灸临床实践指南》关键临床问题和结局指标的研究

ObjectiveFormulating critical clinical questions and outcomes is essential for developing clinical practice guidelines (CPGs). This study aims to formulate the key clinical questions and outcomes for the CPG on acupuncture and moxibustion for allergic rhinitis (AR).MethodsPICO (patient, intervention, comparator, and outcome) question survey, Delphi survey, and consensus conference of the guideline development group (GDG) were employed. PICO questionnaires were used to gather and analyze the target users' key demands and interests. The GDG then selected the critical clinical questions and outcomes via a mixed method of Delphi survey and consensus conference.ResultsFifteen potential clinical questions and ten types of outcomes were formulated based on the analysis of 123 responses from seventeen countries on five continents. After two rounds of the Delphi survey and complete discussions, a consensus was reached by the GDG that all potential questions were included. After three rounds of the Delphi survey and complete debate, the consensus was reached that nine outcomes were considered important.ConclusionFifteen key clinical questions and nine important outcomes were formulated for the CPG. These covered issues elicited the most attention from global users in acupuncture therapy and AR. The results will contribute to the CPGs development and future clinical studies.     

用“营卫精神模型”假说阐释抑郁障碍病机

以《黄帝内经》关于营卫与精神活动的论述为依据,提出以营卫运行为核心,涉及脏腑、血脉、九窍的"营卫精神模型"假说,用以解释精神活动。认为精神活动是在心主导下脏腑气化产生的,营卫充养五脏,支持脏腑气化,是精神活动的能量来源;营卫循行周身,沟通脏腑、血脉、九窍,传达神机,协调脏腑生克制化,是精神活动的调节机制。以该假说阐释抑郁障碍的病机,认为"卫气郁痹,神机抑遏"是抑郁障碍的基本病机,卫气郁痹可导致脏腑气化失司、营卫失和、血脉损伤、九窍不利等病机变化。     

足三阴经经络腧穴诊察在妇科病症针灸诊疗中的应用

以3种代表性的妇科病症（痛经、盆腔炎、多囊卵巢综合征）为例，探讨经络腧穴诊察在妇科病症针灸诊疗中的应用方法。临床诊疗时，在患者足三阴经小腿段的循行部位进行循按诊察，探求经络腧穴的阳性反应（颜色、形态、皮温变化及感觉异常等），于此阳性反应处进行针灸治疗可以提高临床疗效。经络腧穴诊察可为经络辨证提供依据，从而指导选穴处方；有助于明确病性之虚实寒热，指导刺灸方法的选择；辅助判断疾病的预后和转归。